Prof. Eileen RothPsychology 11Child PsychologyParenting Children With Attention Deficit DisorderAttention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that is usually first evident in childhood and can affect the individual into adulthood. At one time it was thought to be only a behavior problem, latert was redefined in the 50s as “minimal brain dysfunction,” before it finally metamorphosed into today’s ADD and ADHD. ADD is a neurobehavioral disorder and is characterized in the DSM IV as inattention, hyperactivity, and impassivity that is presebefore the age of seven and which causes impairment with social, academic or occupational functioning. The problems that children with ADD/HD go through affect many aspects of a child’s life.
The usual developmental tasks can become extremely diffilt for these children, and especially frustrating for the parents. The main areas that are affected in the lives of attention different children are those of self-esteem, social relationships, their academic skills, and most importantly their family rationships namely those between the parent and ADD/HD child. If a child is able to be diagnosed early in life, the parent is at an advantage over one who has no idea that their child has this disorder. Parent training can be one of the most importt and effective interventions for a child with ADD. In the aforementioned difficult areas where ADD can cause the most problems to be prepared as a parent for the situations that their children and they themselves as parents face can be lessened and caeven be turned into productive learning tools. CompuServe, on the World Wide Web has a forum that is specifically dedicated to Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder.
It is one of the best resources for individuals with ADD/HD, children, parents and therapists. Onerticle, was written by Pamela Darr Wright, a licensed social worker specializing in child development in children with learning and attention disorders. In her article she explained each stage of child development and how kids with ADD experience thesetages with much greater difficulty and cause a lot of strain on the parent/caregiver-child relationship. She began with the infant stage of development where some of the most critical developmental tasks occur.
These are the tasks of calming themselvehow to use the senses to learn about the world, and develop trust with the parent/caregiver. Infants that may later be diagnosed with ADD/HD are often labeled as “colicky,” “hyper-excitable,” “irritable,” or “unsoothable. ” They are very active, easidistracted, and over-reactive to stimuli. The parents of these infants often respond to a ‘difficult’ baby with confusion and alarm. The interaction between nurturing parent(s) and child is critical. When parents cannot ‘cope’ with their baby, they ually assume it is their own fault as failing parents which begins a relationship laden with guilt that can continue on through the entire relationship with their child.
The second psychosocial developmental stage which occurs in the Toddler years, is that of separation. The period wherein the child develops the ability to hold a mental image of the parent in his mind. As the child accomplishes the task of separating,strong sense of autonomy and confidence develops. It is during this stage also where the toddler develops ideas and concepts and is learning to accept limits and to tolerate frustration and to recover from disappointments. Wright explains that theseevelopmental tasks can present significant problems for toddlers with ADD/HD. Typically, these youngsters have difficulty tolerating frustration and may be emotionally over-reactive.
Parents describe them as “all-or-nothing” children who have difficulcalming themselves. They tend to fall apart easily, dissolving into tears of frustration when needs and wants are not met immediately. One of they most important things that a parent can do for their ADD/HD child is to be consistent. When children he predictable consequences to their behavior it helps them to learn more quickly.
For example, a child with ADD who wants a toy while shopping with his mother may immediately begin to throw a tantrum when she refuses to comply to her toddler’s wishes. n order to discourage further behavior there are many behavioral methods which one can use to form a discipline strategy. Most parenting classes talk about how to discipline your child. There are two main principles taught. The first, is the parentsonsistency ie. not giving in to the child throwing a tantrum and pulling the child aside for a time out or even ignoring the tantrum altogether; and the second, is parent’s control of their own emotions in order to use less negativity toward their childA technique called “charting” is often the first step in any behavior modification program.
It requires that parents specifically define the behavior they are concerned about so that it can be observed and counted. Charting makes parents more awaref their own behavior and children more aware of a problem behavior. During pre-school where the child begins to develop a solid identity and self-concepts are emerging, Wright gives the common behavioral signs exhibited by many children with attentional deficits–high activity levels, poor persistence, interpersonal/er group problems, and difficulty modulating behavior and impulses, with aggression, tantrums, silliness, bossiness, and impulsivity. These are often beginning to create problems for the youngster. He may be fearful, confused, manipulative, or avoidanADD and other learning disabilities are strong contributors to the emergence of over-anxious disorders of childhood, including school phobias.
Parents who are aware of their childs attention difficulties can help their youngsters and in the long run,hemselves, by avoiding emotional reactions such as anger, sarcasm, and ridicule. Dr. Janet Z. Giler Ph. D. states that parents need to begin observing what their child’s strengths and weaknesses are.
In addition, they need to know which behaviors are uer the child’s conscious control and which are not. Dr. Giler gives a solution for discovering whether their child is unable to follow the parents request or if it is simply the child’s non-compliance. To define non-compliance, you must ask the questiof “Can your child control the identified behavior?” If the answer is yes, you then need to ask yourself if your child is choosing to disobey. If the answer is yes, then you are defining non-compliance.
However, for many ADD/LD children, a behaviocan be an inability even if there are times when the child can control the behavior. The subject of movement is a good example. When children with ADD are highly interested or scared, they can control their need to move. Since the parent sees that thcan control their need to move they incorrectly assume that their child has this ability all of the time. Many ADD children use movements to wake up their brains.
Moving helps them to pay attention. However, many parents view their child’s squirmias an act of defiance instead of a behavior which they have trouble controlling. If the parent thinks the child is defying them, they might get angry. If instead they are able to view movement as an inability, parents might instead either ignore it oconstructively use the situation to teach the child to move in ways which aren’t as bothersome to others. Parents can learn how to effectively use positive reinforcement by attending to their child’s positive behavior while ignoring, as much as possiblethe negative behavior.
Without consistent structure and clearly defined expectations and limits, children with ADD can become quite confused about the behaviors that are expected of them. As a normal child shifts from pre-school to elementary school, the major psychosocial tasks of childhood have been dealt with and the child is able to focus his energy on learning in school along with the refinement of interpersonal relationships. Aer entering the educational system, the child with attentional deficits will often begin to struggle. The child may lag behind his peers, academically and socially. Often, ADD children have “social deficits” in that they have difficulty accurately intpreting and processing social information and cues. This “social deficit disorder” as Wright calls it, along with impulsivity, may lead to the development of socially unacceptable behaviors.
Making and keeping friends is a difficult task for children th ADD. A variety of behavioral excesses and deficits common to these children get in the way of friendships. They may talk too much, dominate activities, intrude in others’ games, or quit a game before it is done. They may be unable to pay attentiono what another child is saying, not respond when someone else tries to initiate and activity, or exhibit inappropriate behavior.
Parents of a child with ADD need to be concerned about their child’s peer relations. Problems in this area can lead to loniness, low self-esteem, depressed mood, and increased risk for anti-social behavior. Parents can help provide opportunities for their child to have positive interactions with peers. There are a number of concrete steps that parents can take: Setting up a home reward program that focuses on one or two important social behaviors. Observing the child in peer interactions to discover good behaviors and poor, or absent, behaviors.
Directly coaching, modeling and role-playing important behaviors. “Catching the child” at good behavior so as to provide praise and rewards. Other strategies include structuring initial activities for the child and a friend that are not highly interactive, such as trips to the library or playground; using short breaks from peer interactions when the arousal level becomes high; and working treduce aggressive behavior in the home. ADD children (and adults) are usually more oriented to visual and kinesthetic learning and right brain thinking.
Unfortunately, there is a structural dilemma in the educational system because educators tend to be auditory learners that are left brainriented with a systematic way of thinking. However, there are exercises and tools that can be used by parents to help their child in the area of academics. One idea is to make a written agreement with your child in which the child agrees to do his oher homework every night or agrees to work their hardest at a higher grade in a specific subject in return for a privilege or reward he/she selects. Therapists suggest that parents not be afraid of using monetary rewards as encouragement as it really esn’t matter what is used as long as it produces the desired behavior or results in the child. Another plus side to this method is that by succeeding in anything, the ADD child is slowly able to develop the confidence and skills to tackle other more diicult situations. Paradoxically, many children with ADD are also exquisitely sensitive to feedback from others.
As the child becomes aware of his differences from others, is shunned or teased by peers, is criticized by teachers for being unable to remn in control, the child begins to develop a negative self image, low self-esteem, depression and anger. What significant others (parents, teachers) tell the child about himself has a powerful impact on his developing self-concept. The child begins to ew himself as he is viewed by others. Told repeatedly that he “could do better if he would only try”, he begins to feel that he is worthless. sadly these negative feelings about the self persist through life if parents don’t take care to protect theirhild’s self-view. Children with ADD often need their parents to identify their areas of strength.
School work is mostly left-brain sequential learning. Sports, dance, music, video, computer games, magic shows and other creative right brain activitiesre usually areas of strength that can be emphasized outside of school to create success. In order for parents able to help their attention challenged children conquer many of the hurdles that go along with Attention Deficit Disorder, they will have to deal with the child with patience and understanding above all else. Complicating the famy situation is the fact that ADD is often genetically transmitted from one generation to the next.
Thus, we often find an ADD child being raised by an ADD parent who was never diagnosed and who had a very limited understanding of why the child is havinproblems (which may, incidentally, mirror problems that the parent himself experienced as a child. Medication helps to relieve many symptoms of distractibility and hyperactivity in about 75% of children. Most children are treated with psychostimulantedications (Ritalin, Cylert, Dexedrine). Others respond to a carefully titrated blend of antidepressant medication and/or psychostimulants. And still others usually in cases where parents are against the use of drug therapy there are other sometimes facostlier treatments such as EEG Biofeedback or therapy or counseling. Two primary federal laws apply to the education of children with ADD.
The Individuals With Disabilities Education Act (IDEA) and section 504 of the Rehabilitation Act of 1973. Accoing to federal law, a school is responsible for providing an educational diagnosis of a child if the school district and parent believes that a child has a disability. Many new advancements educationally have been made recently in which children can reive a quality education that takes into account their special needs. Any treatment is far better than none at all and the knowledge that one’s child has ADD/HD allows parents to be prepared for the difficult areas of their child’s developmental groh and within all other areas of their life including academics, peer and social relationships, self-esteem, and family relationships.
REFERENCES1. American Psychiatric Association (pub. ) (1994)Quick Reference To The Diagnostic Criteria From DSM-IV. 2.
Pamela Darr Wright, LCSW CompuServe 75116,364″Attention Deficit Disorder in Children: Developmental, Parenting andTreatment Issues” Copyright 1993 (Retrieved from the World Wide Web, November 1998)3. Janet Z. Giler, PhD. , “What is Attention Deficit Disorder and How Is It Diagnosed?”(Retrieved from the CompuServe ADD/HD Forum on the World Wide Web 11-98 http://home.
earthlink. net/~jzgiler/howdoi. htm)4. “Think Fast! The ADD Experience”Underwood Books (pub) Grass Valley, CA. (1996)5.
C. H. A. D. D.
(Children and Adults with Attention Deficit Disorders)http://www. chadd. org6. CompuServe’s Attention Deficit Disorder Forum(Various sources retrieved from the World Wide Web Nov. 1998)